What’s Your Brain Care Magic? How to Prevent Dementia Before It Starts

Podcast Introduction and Dementia Prevention 0:00

We should do what we can in our midlife and later life to try to reduce our risk of dementia as much as possible. So that's the goal of this test. It was developed with a group of clinicians and scientists in Boston, the McCants Center. And it is a 21 point brain score online test that you can take and then discuss with your physician. And the score covers things like smoking, alcohol, activity, and diet. Pretty basic stuff. Nothing too unusual here. There is also a post-test list of things that one might be able to make a change in to improve your brain score. Have you made it past menopause or are you going through it now? I'm Dr. Pat McShane and on the Women's Health Span Voices Podcast. I'll guide you through the health challenges of the menopausal years and beyond, guiding the way to thriving in this powerful era of your womanhood. Hello and welcome. Today I thought we would dive a little bit deeper into the subject of dementia, and I'm going to try to convince you to perform a brain score, which is a very easy online little test that you can take. So why would I want you to do this? Well, the idea here is prevention of dementia. I've been reading very scary statistics, including the one that one in five women during her lifetime will experience dementia. This is so significant

Why Brain Score Matters for Dementia Risk 1:32

and so scary for most of us on both a personal level and on a public health level that I think we should be doing everything we possibly can do to avoid this. and the brain score falls into this category. So we're trying to invoke a primary prevention model here. In other words, try to keep people from getting dementia in the first case rather than trying to treat it after people have some memory loss or full-on dementia. The reason for this is that there are some examples of public health interventions that have really changed the outcome of some very significant diseases in Americans and other developed countries. Examples of this are cigarette smoking and the incidence of lung cancer and heart disease and activity and diet modifications that many people have adhered to to reduce their risk of heart disease. I think in 20 years we may look back and say, well, this is what we started to do that diminished our risk of dementia, and I certainly hope so. For a long time, we thought that dementia was just something that happened. There wasn't anything we can do about it. And there haven't really been highly successful drug interventions until recent time either. So this is even more reason to try to avoid dementia. But over the last several decades, it's become more and more clear that there are things we can do and there are certainly lifestyle issues that will increase our risk of becoming demented in our older years. There are also genetic factors and we can't do much about this. And some things like brain trauma from concussions and so on that we can't alter.

But in my opinion, we should do what we can in our midlife and later life to try to reduce our risk of dementia as much as possible. So that's the goal of this test. It was developed

Evidence From UK Biobank and Lifestyle Risk Factors 3:40

with a group of clinicians and scientists in Boston, the McCants Center. And it is a 21 point brain score online test that you can take and then discuss with your physician. And the score covers things like smoking, alcohol, activity, and diet. Pretty basic stuff, nothing too unusual here. There is also a post-test. list of things that one might be able to make a change in to improve your brain score. Well, how do we know that this brain score has any validity? Well, a UK biobank study that was recently published looked at people with certain risk factors for memory issues and dementia. And these included some medical conditions and some social and lifestyle conditions and things like blood pressure problems, inactivity, smoking, obesity, and so on. And as with the other UK Biobank study participants, they were followed over a number of years and there were good data about the medical outcomes that occurred with these people. They used a 19-point scale, but it covered the same basics as the McCants scale. The median score on this 19-point test was 12, and they stratified the respondents, the participants in the study, in five-point increments. There were over 400,000 subjects that were included, of whom more than 50 % were women. And the mean age uh was 57, so in the age range that we're aiming for here in this video series. And what they found was every five point increment cost people about 30 % of their cognition, of their brain score. In other words, if you smoke and you drink a little bit too much and, your diet isn't great compared to someone who is at a higher level, that might cost you around 30 % on the memory tests that were performed. as part of this study. That demonstrates to me pretty powerfully

Coaching and Behavior Change Improve Memory 6:12

that these lifestyle and medical factors make a difference in your risk of dementia. What about altering our behavior? How do we know that that's going to make a difference? Let's say we've smoked or not eaten that well for many years. Why do we think that we can change that situation? Well, a recent study from Kaiser Permanente in Washington, the SMART study, looked at people who had risk factors like inactivity, smoking, high blood pressure, and so on, and randomized them to either a close following with coaching versus a more traditional, conventional medical advice, here's some things that you might try on your own. For the coaching, the subjects were able to choose the things that were issues such as, let's quit smoking, let's get more active, let's work on our diet here. And the coaches were a variety of different classes of individuals depending on what was most needed for that particular subject. And what they found was that these folks had about a 75 % improvement in their memory score, which was done at the beginning and at the end of this trial compared to those who were randomized into the minimal intervention side of things. So again, to me, this seems like a pretty powerful argument that it makes a difference what we do and that we can intervene in certain ways, not maybe in everything, but in some powerful ways to uh reduce our risk of dementia and improve our memory in the current moment. So I hope I have convinced you to try the Brain Score, talk about it with your physician, and put comments in the comments below about how

Closing Remarks and Call to Action 8:09

you found it. So if this is the kind of information that's important and useful to you, I'm really happy for that. And I would like you to like and subscribe. And I hope to see you again soon. Thanks so much. Thanks for listening to the Women's Health Span Voices Podcast. If today's episode spoke to you, Follow the show and share it with a friend ready to take charge of her health. And please leave a review. It helps more women find us.